A hospital perspective on the cost-effectiveness of beta-blockade for prophylaxis of atrial fibrillation after cardiothoracic surgery

Clinical Therapeutics
Effie L GillespieCraig I Coleman

Abstract

Prophylactic beta-blockade is the recommended strategy for suppressing atrial fibrillation after cardiothoracic surgery (CTS). However, beta-blockade's impact on the hospital length of stay (LOS) and other economic end points has not been adequately assessed. The present evaluation sought to determine whether beta-blocker use after CTS is a cost-effective strategy for the prevention of postoperative atrial fibrillation (POAF). This was a piggyback cost-effectiveness analysis of a prospective cohort evaluation comprising 1660 patients undergoing CTS at an urban academic hospital from October 1999 to October 2003. Patients receiving beta-blocker prophylaxis were matched 1:1 with control patients not receiving prophylaxis based on age >70 years, valvular surgery, history of atrial fibrillation, male sex, and use of preoperative digoxin or beta-blockers. The incidence of POAF, total hospital costs, and LOS were compared in each group. Nonparametric bootstrapping analysis was performed to examine the study results as part of a quadrant analysis and to calculate CIs for the incremental cost-effectiveness ratio. LOS and total costs were also compared in patients with and without POAF, regardless of beta-blocker use. Use of prophylacti...Continue Reading

References

Oct 1, 1983·Annals of Emergency Medicine·R M ElenbaasP G Cuddy
Sep 1, 1993·The Annals of Thoracic Surgery·L L CreswellJ L Cox
Oct 9, 1996·JAMA : the Journal of the American Medical Association·L B RussellM C Weinstein
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Apr 15, 2004·JAMA : the Journal of the American Medical Association·Joseph P MathewUNKNOWN Multicenter Study of Perioperative Ischemia Research Group
Dec 31, 2004·Stroke; a Journal of Cerebral Circulation·Mark J Alberts, Elisabeth Tournier-Lasserve

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Citations

Feb 29, 2008·Journal of Anesthesia·Yuko YoshidaAtsuhiro Sakamoto
Aug 25, 2009·Pharmacotherapy·Craig I ColemanC Michael White
Jul 28, 2018·Cardiology Research and Practice·Pattamawan KosumaArom Jedsadayanmata

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